Utility of dynamic MRA in the evaluation of male erectile dysfunction
- PDF / 1,763,845 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 86 Downloads / 144 Views
SPECIAL SECTION: MALE PELVIS
Utility of dynamic MRA in the evaluation of male erectile dysfunction Alexandra Roudenko1 · Rand N. Wilcox Vanden Berg3 · Christopher Song2 · Martin R. Prince2 · Darius A. Paduch4,5 · Daniel Margolis2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Purpose To assess the efficacy of time-resolved MR angiography (MRA) in evaluating penile vasculature in patients with clinically suspected vascular anomalies contributing to their erectile dysfunction correlating with penile doppler ultrasound (PDUS) findings and clinical outcomes after surgical intervention. Methods Men (n = 26) with signs of early vascular shunting on PDUS underwent time-resolved, contrast-enhanced (0.1 mMol/kg gadobutrol at 1 ml/s followed by saline flush) 3-dimensional spoiled gradient echo T1-weighted MRA sequence performed over 3 min with 4.6 s frame rate after intracavernosal injection of an erectogenic agent. Additional T1- and T2-weighted sequences were performed for anatomic co-localization and tissue characterization. MRA images were evaluated for early filling of draining veins as well as arteriovenous malformations and fistulas and correlated with findings at surgery. Results 29 MRA examinations on 26 patients (mean age 39 years) demonstrated abnormal early venous drainage (n = 22) as well as diminutive/delayed cavernosal enhancement (n = 3), incomplete tumescence (n = 2), and combined arterial inflow/ venous outflow disease (n = 1). The MRA had a concordance of 85.2% at determining the presence, or lack thereof of a shunt/AVM when compared to PDUS. Conclusions Time-resolved MRA allows for both temporal and spatial resolution with visualization of both arterial and venous abnormalities which may be suggested with a screening PDUS examination. This technique allows us to provide detailed anatomic information prior to any surgical intervention. Keywords Erectile dysfunction · MR angiography · Time-resolved MRA · Venous leak · Dynamic MRA
Introduction Erectile dysfunction (ED), generally defined as the consistent or recurrent inability to attain and/or maintain penile erection sufficient for sexual satisfaction [1–3], may significantly reduce quality of life [4] for as many as 30 million * Alexandra Roudenko [email protected] 1
Department of Radiology, Mount Sinai Health System, 1000 10th Ave, New York, NY 10019, USA
2
Department of Radiology, Weill Cornell Medicine, 1305 York Ave, New York, NY 10021, USA
3
Department of Urology, Weill Cornell Medicine/New York Presbyterian, 525 E 68 St, New York, NY 10065, USA
4
Arthur Smith Institute for Urology, Northwell Health, 1000 Northern Blvd, Ste 120, Great Neck, NY 11021, USA
5
Bioimaging Lab, Consulting Research Services, Inc, North Bergen, NJ, USA
men in the United States [5] with 8–52% of men throughout the world experiencing some degree of ED symptoms depending on the specific population being evaluated [3, 5–7]. While historically labeled as a disease of older men, ED is experienced by men of all age
Data Loading...
